Approximately 99,000 people die every year from healthcare-associated infections and are referred to as hospital-acquired infections, or HAIs. This is due partly to the fact that microbial communities develop in a hospital or other healthcare related facilities. Means to control the spread of microorganisms within hospital or other healthcare related facilities are therefore paramount.
How microbial communities persist and change in indoor environments is of immense interest to public health bodies and scientists. Recent studies show that humans alter the microbiome of a space when they begin to occupy that space. The length of time taken to demonstrate a change (e.g., on the carpet of a bedroom) can range from four to six days, suggesting that the rate of succession in a microbial community can be influenced by the way in which the occupants interact with that space. In a hospital setting, continuously admitting and discharging patients from hospital rooms creates a persistent and an ongoing problem. The building materials (e.g., HVAC system, paint, flooring type, etc.) also influence both the rate of succession in communities and the community composition.
Contrary to public expectation, the potential for contracting a microbial pathogen is highest within a hospital environment, and these infections are much more likely to be fatal. The Centers for Disease Control and Prevention identified 1.5 million cases of environmentally-contracted identifiable diseases in the United States for 2002, 15,743 of which resulted in death (1%). In comparison, during the same year, estimates of HAIs in the United States was 1.7 million, a rate of 4.5 infections per 100 hospital admissions, which contributed to an astonishing 99,000 deaths (6%). This sobering statistic places HAIs as the sixth leading cause of death, ahead of diabetes, influenza/pneumonia, and Alzheimer's. Also, the cost of extended the stay of a patient due to their contracting an HAI is quite significant.
HAIs, also referred to as nosocomial infections, are usually acquired between forty-eight hours and four days after a patient has been admitted to the hospital. Currently, 5% of patients admitted to U.S. medical facilities are affected, with the total number exceeding 1 million people with 1.7 million HAIs requiring 170 million patient days. These infections are normally viral or bacterial in origin, but fungal infections have not been ruled out. The vast majority of these cases occur while the patient is being treated for the ailment that resulted in the hospital admission in the first place. Approximately 36% of these infections could be linked to professional error, through improper attention to protocols for cleanliness in the hospital environment. While these numbers are shocking, they also highlight a considerable lack of evidence regarding both the source and development of nosocomial infections.
Microbes reside in many places and the risk of moving waste and soiled linens through hospitals or other healthcare related facilities is real. Aerosolisation happens whenever material, such as soiled linens, is agitated. For example, when waste material is thrown into a room or trash bin, or when soiled linens are thrown down a chute, aerosolisation takes place. This aerosolisation creates risk because microbes (fungi, bacteria, viruses) make up a relatively large percentage of the particulates and can be inhaled by staff, patients, and visitors. In addition, these microbes settle and attach to surfaces and to people. When people leave a room and walk down a hall, or in and out of a patient room, in and out of elevators, and generally mix with others in the facility, by so doing they cause the re-aerosolization of these particulates and microbes throughout the facility. Currently, many man-hours of labor are spent in wiping and cleaning surfaces, but most facilities cannot afford to hire and pay enough workers to properly clean all of these areas on a regular and consistent basis. If a system can clean the air before the microbes settle onto surfaces, a large amount of labor costs can be saved, and if the system can function 24/7, a great improvement in the reduction of HAIs can be achieved.
The essential point of any nosocomial infection or HAI is that hospitals can be risky places for those with suppressed immunity. A new patient will be exposed to potential pathogen infection risk during a care-related visit to a healthcare facility, and the risk will be multiplied during invasive treatments. Groups most immediately at risk include patients of advanced age, premature birth, or immunodeficiency. The latter can be developed inside the hospital due to drugs, illness, or irradiation, all of which can be a direct result of treatments. The rise in deaths related to Clostridium difficile and methicillin-resistant Staphylococcus aureus bacteraemia in the United Kingdom over the last 10 years has been shocking, with more than 10,000 deaths per year related to these HAIs. While the factors associated with the disease etymology and pathogenicity have often been explored, and intervention strategies expounded, the problem is not going away. There have, however, been regional successes that have made considerable ground in the removal of specific HAIs. Such successes have led to calls for action from the healthcare community, especially regarding a call for data to enable a reaction to existing and emerging threats.
Recent data, the first of its kind, indicates that high concentrations of microbes, particulates, and potential pathogens are present where soiled materials and waste are generated and transported to holding rooms and at the bottom of gravity chutes in hospital and healthcare settings. For example, in one study conducted at the University of Chicago Hospital, the following bacteria, some of which are potential pathogens, were found to be present in the gravity chute on the 9th floor and in the basement gravity chute in greater than or equal to 0.7% relative abundance: Firmicutes/Bacilli/Bacillales/ . . . /Staphylococcus, Actinobacteria/Actinobacteria/Propionibacteriales/ . . . /Propionibacterium, Actinobacteria/Actinobacteria/Corynebacteriales/ . . . /Corynebacterium, Firmicutes/Bacilli/Lactobacillales/ . . . /Lactobacillus, Firmicutes/Bacilli/Lactobacillales/ . . . /Streptococcus. Bacteroidetes/Cytophagia/Cytophagales/ . . . /Hymenobacter, Actinobacteria/Actinobacteria/Micrococcales/ . . . /Microbacterium, Cyanobacteria/Chloroplast, Proteobacteria/Betaproteobacteria/Burkholderiales/ . . . /Herbaspirillum, Firmicutes/Clostridia/Clostridiales/Lachnospiraceae, Actinobacteria/Actinobacteria/Micrococcales/ . . . /Micrococcus, Firmicutes/Clostridia/Clostridiales/ . . . /Finegoldia, Firmicutes/Bacilli/Bacillales/ . . . /Bacillus, Proteobacteria/Gammaproteobacteria/Pseudomonadales/ . . . /Acinetobacter, Proteobacteria/Betaproteobacteria/Burkholderiales/ . . . /Massilia, Firmicutes/Clostridia/Clostridiales/ . . . /Anaerococcus, and Bacteroidetes/Flavobacteria/Flavobacteriales/ . . . /Chryseobacterium. 
These findings pose a risk factor, previously unknown and unstudied, not only in hospital and healthcare settings, but also in hospitality settings (such as motels and hotels, etc.), entertainment venues, apartment buildings, office buildings, and other settings or venues where waste and soiled items are being moved and, therefore, agitated-even if only slightly causing aerosolisation. These rooms are very often untreated, with limited or nonexistent air exchanges, and typically no air filtering. As discussed above, hospital and healthcare settings are unique in that the populace frequenting there may be vulnerable, sick, and/or compromised and are, therefore, of a particular concern. Thus, there is a need in the art for a system that can address this problem and help mitigate the risk of exposure to patients, staff, visitors, and customers in hospital and healthcare settings and other venues. A solution is needed that can track, measure, report, and treat the entire facility in an integrated, transparent manner on a 24/7 basis. Currently, there are no standards imposed on air filtration in hospitals and healthcare settings, but as more studies are done, regulations are sure to follow. The ability to monitor in real time and report on air quality will help facilities to prepare for and comply with the expected coming regulations.
Smoke evacuation systems provide a portable solution to eliminate the smoke byproduct generated during surgical procedures that use a laser or electrosurgical unit. The thermal destruction of tissue creates the smoke byproduct, referred to as a surgical plume. Surgical plumes have contents similar to other smoke plumes, including carbon monoxide, polyaromatic hydrocarbons, and a variety of trace toxic gases. As such, they can produce upper respiratory irritation, and have in-vitro mutagenic potential. Local smoke evacuation systems like the PlumeSafe® Turbo™ have been recommended by consensus organizations, and may improve the quality of the operating field. The PlumeSafe® Turbo™ employs four-stage filtering: (1) a pre filter; (2) an activated carbon filter; (3) a UPLA (Ultra Low Particulate Air) filter; and (4) a post filter. The PlumeSafe® Turbo™ cannot filter the air in a room to eliminate the broad spectrum of pathogens that can cause HAIs. It does not have the right filters for this purpose, nor the capacity to process the volume of air necessary to filter a room.